Good evening, Madam Chair and members of the science and research committee. I would like to thank you for the opportunity to testify to you today.
My name is Dao Nguyen. I speak to you as a physician working at McGill University's teaching hospital as a professor of medicine and microbiology, as a researcher who studies difficult-to-treat bacterial infections and, last, as the founding director of the McGill AMR Centre and a new AMR Quebec network, where I lead the efforts to structure and mobilize a diverse ecosystem of over 150 academic researchers at McGill University and across Quebec with government, public and private partners across the human, animal and environmental health sectors.
First, I would like to paint a brief picture of what AMR looks like through the lens of a physician. I would like you to imagine that a loved one is diagnosed with cancer, which is curable but requires chemotherapy. During chemotherapy, which significantly weakens one's immune system, you develop a fever, a typical sign of infection. For this, you are immediately prescribed antibiotics, for which I might do a test to figure out what kind of infection you have. If the infection is caused by bacteria not resistant to the antibiotic prescribed, it will likely work. This will take a few days of antibiotics, and no one will think twice about it.
However, if you have an infection caused by a drug-resistant bacteria, particularly one resistant to carbapenems, a powerful type of antibiotic that is considered a last resort, then the initial antibiotics will not work. With the current diagnostic tests at hand, it may take three to five days to get an answer, if at all, about what microbes caused the infection and whether the microbes are drug-resistant. During this time, the infection can overwhelm the body, with the risk of dying increasing to upwards of 50% with treatments that are more toxic and complicated, if available at all.
The scenario could happen to any patient who has surgery, gets a pacemaker, develops pneumonia or suffers a wound. All of these important medical interventions carry a risk of infections and complications, and they could be jeopardized if prevention or treatment of infections were no longer effective. At best, this means an average of a one-week-longer hospital stay for each case of infection, and at worst, this means risky and unsuccessful procedures or treatments or deaths for countless conditions, from hip replacements to cancer. The rates of these carbapenem-resistant bacteria—that is, a resistance to a last-resort antibiotic—have already reached 70% to 80% in certain regions of the world today, as we speak. In Canada, the rates are much lower, but the trends are alarming, with rates having gone up as much as tenfold in the last 15 years, so the AMR crisis is knocking at our door, and we're not equipped for this.
To respond to this, we are in dire need of innovative solutions. We need new treatments to deal with the drug-resistant bacteria; we need diagnostic tests that are much faster and more accessible to know when we are dealing with drug-resistant infections and what antibiotics to use, and we need surveillance systems that are more comprehensive and timely. To get there, research and innovation done in a collaborative manner are essential to the solutions to addressing the AMR crisis. This is recognized by the pan-Canadian action plan, numerous national action plans globally, and reports, including from the WHO.
Where do research and innovation largely come from? Academia: With our community of researchers and teachers, we are a major asset and an important part of the solution.
First, academic research is a critical source of innovation. For example, McGill ranks first in North America as the university that has launched the greatest number of research-based start-up companies. In 2023 alone, there were 28 companies, most of them in the life sciences and medical technologies sector. This speaks to the potential for AMR, but the research and development ecosystem in Canada to nurture early discoveries is largely lacking, as you have already heard from Professor Wright earlier this afternoon. Beyond Canada, we know that academic inventions and founders are responsible for more than a quarter of all medicines approved in the last 20 years, with trends going upward in the last 10 years. For certain medical conditions, this represents over 80% of treatment.
Second, as a researcher myself, who interacts with and mobilizes hundreds of my colleagues around AMR, I can say that academic research in Canada has notable strengths and existing initiatives upon which we need to build. For example, in Quebec, Mila, a world-class AI institute founded by Professor Yoshua Bengio, whom many of you may know as the grandfather of deep learning in AI, has an incubator that has launched over 50 start-up companies and projects that bring AI tools to antibiotic discovery.
Last, academic communities are important conduits to mobilize and structure the AMR ecosystem. Our experience with the AMR Quebec network is a good start and an example.
What do we need now? We need to build and support an AMR ecosystem that integrates academic research and innovation with government and public stakeholders, industry and end-users.
To get this, we need strong leadership and persons and entities dedicated to AMR with a specific mandate to mobilize political will and resources and to coordinate activities across sectors and jurisdictions.
We need somebody who can be heard by both decision-makers nationwide and professionals; we need a government structure to organize this AMR ecosystem, and we need resources commensurate to the problem of AMR—